Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
90 Cards in this Set
- Front
- Back
|
NSAIDS(drugs that have anti-inflammatory properties) include? (cox 1&2)
|
aspirin,ibupropfen(Motrin, Advil, others),naproxen (Naprosyn), and celecoxib(Celebrex)
|
|
|
Which one cox inhibitor lacks anti-inflammatory properties?(cox 2 only)
|
acetaminophen (tylenol)
|
|
|
What serious side effect can aspirin cause?
|
gastric ulceration
|
|
|
What chemical family does aspirin belong to?
|
salicylates
|
|
|
What is aspirin commonly known as
|
acetylsalicylic acid or ASA
|
|
|
How does aspirin reduce fever?
|
by inhibiting Cox 2 which thereby inhibits pyrogen induced sythesis of prostaglandins
|
|
|
Professional labeling of aspirin now recommends low doses of asprin for prevention of stroke and acute MI what is the dose?
|
75 to 325 mg/day
|
|
|
Name 3 adverse effects resulting from the inhibition of prostaglandins
|
gastric ulceration, bleeding and renal impairment
|
|
|
What is the term used for aspirin toxicity
|
salicylism
|
|
|
Name 5 known therapeutic uses for aspirin
|
suppression of inflammations, analgesia, dymennorhea, fever redcution, suppression of platelet aggregation
|
|
|
How does the dose of aspirin for arthritis compare to the dose used for analgesia
|
considerably larger
|
|
|
For what types of pain is aspirin most effective?
|
joint pain, muscle pain and headache
|
|
|
For what type of pain is aspirin relatively ineffective against?
|
pain of visceral origin
|
|
|
Why is aspirin not recommended for children?
|
Reyes syndrome
|
|
|
Why is aspirin effective for treating dysmennorhea?
|
inhibits synthesis of prostaglandins, promotes uterine contraction and relieves cramping
|
|
|
What would be considered a low dose aspirin to reduce the risk of stroke or MI
|
75 to 325 mg/day
|
|
|
Name 2 sites of absorption for aspirin
|
rectum and small intestine
|
|
|
How likely is aspirin to cause adverse effects when admistered short term in anagesic or antipyretic doses?
|
rarely causes adverse effects. Toxicity is common when treating inflammatory disorders
|
|
|
What are the most common gastrointestinal effects of aspirin?
|
gastric distress, heartburn and nausea
|
|
|
What can result from blood loss due to GI irritation with chronic aspirin use?
|
anemia
|
|
|
What life threatening adverse effect may occur with long term high dose therarpy?
|
life threatening gastric ulceration, perforation and bleeding
|
|
|
Name 5 factors that might place a person at greater risk of ulceration when taking aspirin
|
age, hx of pud, previous intolerance to aspirin or other NSAIDS, smoking, alcholism
|
|
|
When should aspirin be d/c prior to sx
|
at least one week because it can promote bleeding by inhibiting platelet aggregation
|
|
|
Name four overt signs of salyicylism?
|
tinnitus, sweating, headache, dizziness
|
|
|
According to the CDC when should aspirin and other NSAIDS be avoided in children and teenagers?
|
influenza and chicken pox
|
|
|
What does pregnancy category risk D mean?
|
evidence of fetal risk, but benefits from use outweigh potential for harm
|
|
|
Name 2 common brand names for ibuprofen
|
advil, motrin
|
|
|
Name 4 brand names for naproxen sodium
|
aleve, anaprox, naprelan, and naprosyn
|
|
|
Acetaminophen differs from aspirin in that it?
|
is devoid of anti-inflammatory and anti-rheumatic actions
|
|
|
Why doesn't acetaminophen reduce inflammation?
|
it doesn't inhibit prostaglandin synthesis outside the CNS.
|
|
|
What is the benefit to using acetaminophen over aspirin in children?
|
no link to Reyes syndrome
|
|
|
What serious adverse effect is a greater risk when large doses are combined with alcohol?
|
increased risk of liver injury
|
|
|
Name two populations of patients where acetaminophen is preferred over aspirin?
|
children suspected of influenza or chicken pox, and adult with peptic ulcer disease or aspirin hypersensitivity
|
|
|
Namea specific antedote to acetaminophen overdose
|
acetylcysteine (mcuomyst, acetadote)
|
|
|
aspirin can protect against MI, stroke and other thrombotic events but protections against MI is limited to men and women of what age?
|
over 65
|
|
|
Because of its antiplatelet actions, aspirin does what to the anticoagulant response to warfarin?
|
intensifies
|
|
|
What is the difference between infiltration and extravasation?
|
infiltration= seepage of nonvesicatnt solution into surrounding tissues
extravastaion= seepage of a vesicant substance into the tissues that causes blisters, tissue sloughing and necrosis |
|
|
If there is extravastion at an IV sie, what should be done?
|
elevate extemity and apply cold compresses
|
|
|
How freguently should an IV site be rotated to prevent phlebitis?
|
at least every 96 hours
|
|
|
Define phlebitis
|
inflammation of the vein due to mechanical irritation or infusion of irritation solutions or sepsis
|
|
|
Describe the appearance of an IV site that has phlebitis
|
redness, pain and warmth at the site, lcoal swelling ,palpable cord along the vein, sluggish infusion rate
|
|
|
What are the signs of fluid overload?
|
weight gain, edema, HPT, SOB
|
|
|
How much more common is an adverse drug reatction inthe elderly than young adults
|
ADR's are 7 times more common in the elderly
|
|
|
What percent of hospital admissions among older patients result from adverse drug reactions
|
16%
|
|
|
What two non specific symptoms make identifications of adverse drug reactions difficult in older adults
|
dizziness, cognitive impairment
|
|
|
What is the principle reason given for intentional nonadherence to preescribed drugs in the elderly?
|
patients conviction that the drug is not needed
|
|
|
Identify four possible factors that may lead to unintentional nonadherence to prescribed drugs in the elderly
|
forgetfulness, failture to comprehend instructions, inability to pay, and use of complex regimens
|
|
|
what is the most important cause of adverse drug reactions in the elderly?
|
drug accumulation secondary to reduced renal function, polypharmacy, greater severity of illness, multiple pathologies present, greater used of drugs with low therapeutic index, poor patient adherence
|
|
|
What is the most reliable test for kidney function in the elderly?
|
creatinine clearance
|
|
|
Name two terms that may be used for drugs given to treat anxiety
|
antianxiety agents or anxiolytics. (an older term is tranquilizers
|
|
|
Define opioid
|
a gereral term defined as any drug natural or synthetic that has actions similar to those of morphine
|
|
|
Define the term opiate
|
more specific and applies only to compounds present is opium such as morphine or codeine
|
|
|
Name 3 families of enodogenous opioid peptides
|
enkephalins, endorphins, dynorphins
|
|
|
Identify the three major goups of drugs that bind to opiate receptors
|
agonist, partial agonist, antagonist
|
|
|
What effects do agonist-antagonist opioids such as pentazocine have
|
antagonize analgesia
|
|
|
What is the principal use for pure opioid antagonists?
|
reversal of respiratory and CNS depression caused by overdose with opioids
|
|
|
In addition to pain relief what are 4 other actions of morphine
|
drowsiness, mental clouding, anxiety reduction and euphoria
|
|
|
How soon might respiratory depression effects occur after an IV injection of opioid
|
7 minutes
|
|
|
How soon might respiratory depressant effects occur after an IM opioid injection
|
30 minutes
|
|
|
What effect do opioid have o BP
|
lower by blunting the barorectptor reflex and by dilating peripheral arterioles and veins
|
|
|
Where does opium come from?
|
seedpod of the poppy plant papaver somniferum
|
|
|
What is the prinicipal indication for morphine
|
relief of moderate to severe pain
|
|
|
Name 6 routes used to administer morphine
|
oral, IM, IV, sub Q, epicural and intrathecal
|
|
|
Due to much of the drug being inactivated in the first pass through the liver how are oral doses of morphine affected
|
they need to be substantially larger
|
|
|
describe the classic triad of signs produced with opiod overdose
|
respiratory depression, coma, pinpoint pupils
|
|
|
What opioid with properties like morphine was considered a first line drug of choice in the past but has now declined in use
|
demerol or meperidine
|
|
|
What 2 no opioik analgesics are frequently combined with codeine to produce greater pain relief than either agent alone
|
aspirin or acetaminophen
|
|
|
what is the brand name for oxycodone and aspirin
|
percodan
|
|
|
If a patient taking oxycontin has breakthrough pain what can be done?
|
supplemental dosing with a short acting analgesic
|
|
|
When should pain status be evaluated with a patient being treated with opioids?
|
prior to administration and one hour after
|
|
|
after long term use of benzodiazepines, what more serious reactions to withdrawal may occur?
|
panic, paranoia, delirium, hypertension, muscle twitches, and convulsions
|
|
|
What is the brand name for zolpidem
|
Ambien
|
|
|
What are the 2 most common side effects of zolpidem
|
daytime drowsiness, dizziness
|
|
|
list 3 non drug ways to treat insomnia
|
avoid daytime naps, adhere to sleep schedule, decrease caffeine
|
|
|
What is the trade name for eszopiclone
|
Lunesta
|
|
|
Name two locations where peptic ulcers are most common
|
lesser curvature of the stomach and the duodenem
|
|
|
Name the two major defensive factors against ulceration
|
mucous, bicarbonate
|
|
|
Name the four major aggressive factors for ulceration
|
H.Pylori, NSAIDS, Acid, Pepsin
|
|
|
What is H. pylori?
|
a gram neg bacillus taht can colonize the stomach and duodenem
|
|
|
What are the first and second most common causes of gastric and duodenal ulcers
|
infection with h. pylori, and NSAIDS
|
|
|
name 3 types of noninvasive tests used in the U.S. to test for H pylore
|
breath, serologic and stool tests
|
|
|
Name 5 ab's used to treat PUD caused by h. pylori
|
amoxicillin, clarithromycin, bismuth, tetracycline, and metronidazole
|
|
|
Which of the 5 ab's used to treat PUD can cause a disulfiram like reaction
|
metronidazole
|
|
|
What is the brand name of cimetidine
|
Tagamet
|
|
|
What is the brand name of famotidine
|
Pepcid
|
|
|
How does sucralfate work to promote ulcer healing?
|
crates a protective barrie against acid and pepsin
|
|
|
Which of the 2 most common antacids cause diarrhea
|
magnesium hydroxide
|
|
|
Which of the 2 most common antacids causes constipation
|
aluminum hydroxide
|
|
|
What do diuretics do?
|
increase urine output
|
|
|
Why do diuretic agents that act at distal sites produce relatively scant diureses
|
most of the solute has already been reabsorbed by the time it reaches distal sites
|
